The effect of probiotic supplementation on the gut microbiota of preterm infants
Erica L. Plummer, Jennifer Danielewski, Suzanne M. Garland, Jenny Su, Susan E Jacobs, Gerald L. Murray
Abstract
Introduction. Probiotic supplementation of preterm infants may prevent serious morbidities associated with prematurity. Aim. To investigate the impact of probiotic supplementation on the gut microbiota and determine factors associated with detection of probiotic species in the infant gut. Hypothesis/Gap Statement. Probiotic supplementation increases the long-term colonization of probiotic species in the gut of preterm infants. Methodology. Longitudinal stool samples were collected from a cohort of very preterm infants participating in a blinded randomized controlled trial investigating the impact of probiotic supplementation (containing Bifidobacterium longum subsp. infantis BB-02, Bifidobacterium animalis subsp. lactis BB-12 and Streptococcus thermophilus TH-4) for prevention of late-onset sepsis. The presence of B. longum subsp. infantis , B. animalis subsp. lactis and S. thermophilus was determined for up to 23 months after supplementation ended using real-time PCR. Logistic regression was used to investigate the impact of probiotic supplementation on the presence of each species. Results. Detection of B. longum subsp. infantis [odds ratio (OR): 53.1; 95 % confidence interval (CI): 35.6–79.1; P < 0.001] , B. animalis subsp. lactis (OR: 89.1; 95 % CI: 59.0–134.5; P < 0.001) and S. thermophilus (OR: 5.66; 95 % CI: 4.35–7.37; P < 0.001) was increased during the supplementation period in infants receiving probiotic supplementation. Post-supplementation, probiotic-supplemented infants had increased detection of B. longum subsp. infantis (OR: 2.53; 95 % CI: 1.64–3.90; P < 0.001) and B. animalis subsp. lactis (OR: 1.59; 95 % CI: 1.05–2.41; P =0.030). Commencing probiotic supplementation before 5 days from birth was associated with increased detection of the probiotic species over the study period ( B. longum subsp. infantis , OR: 1.20; B. animalis subsp. lactis , OR: 1.28; S. thermophilus, OR: 1.45). Conclusion. Probiotic supplementation with B. longum subsp. <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-l